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Paper
The social value of candidate HIV cures: actualism versus possibilism
  1. Regina Brown1,
  2. Nicholas Greig Evans2
  1. 1Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Nicholas Greig Evans, Department of Medical Ethics and Health Policy, University of Pennsylvania, 423 Guardian Drive, Floor 14, Philadelphia, PA 19104, USA Department of Philosophy University of Massachusetts, Lowell, 883 Broadway Ave, Lowell, MA 01854 nicholas_evans{at}uml.edu

Abstract

A sterilising or functional cure for HIV is a serious scientific challenge but presents a viable pathway to the eradication of HIV. Such an event would be extremely valuable in terms of relieving the burden of a terrible disease; however, a coordinated commitment to implement healthcare interventions, particularly in regions that bear the brunt of the HIV epidemic, is lacking. In this paper, we examine two strategies for evaluating candidate HIV cures, based on our beliefs about the likelihood of global implementation. We reject possibilist interpretations of social value that do not account for the likelihood that a plan to cure HIV will be followed through. We argue, instead, for an actualist ranking of options for action, which accounts for the likelihood that a cure will be low cost, scalable and easy to administer worldwide.

  • HIV Infection and AIDS
  • Research Ethics

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/medethics-2015-103125

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    Footnotes

    • Twitter Follow Nicholas G. Evans at @neva9257

    • Contributors Regina Brown and Nicholas Evans are the sole authors of this paper.

    • Funding This work is supported by the US National Institute of Allergy and Infectious Diseases (R56 AI114617 and R01 AI114617).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Acknowledgement, post peer-review The authors thank Nir Eyal, Christine Grady, Steven Joffe, Danielle Bromwich, participants at the Harvard Chan School HIV Cure Ethics Symposium, and members of the University of Massachusetts Lowell Department of Philosophy for their comments on early versions of this paper.

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